ESCRS - PO802 - Dalk In A Patient With Keratoconus And Mean Keratometry Of 89.5 Diopters

Dalk In A Patient With Keratoconus And Mean Keratometry Of 89.5 Diopters

Published 2024 - 42nd Congress of the ESCRS

Reference: PO802 | Type: Poster | DOI: 10.82333/np4n-fm89

Authors: Nancy Jurado* 1 , Gabriela Utreras 1

1Cornea,HECAM,Quito,Ecuador

Purpose

To present the technique to achieve successful dalk without perforations in cases of extreme keratoconus and its postoperative management

Setting

A DALK surgery in a patient with long-term keratoconus, rigid contact lens user who presented an average keratometry of 89.5 diopters at Carlos Andrade Marin Hospital (Quito Ecuador)

Methods

A 61-year-old patient with advanced keratoconus underwent deep anterior lamellar keratoplasty with the manual Melles technique. The patient presented a marked alteration of the cornea's posterior curvature, so this most delicate area was surrounded for avoid intraoperative perforation. In the first 24 hours post-operatively, the pacient presented a pseudochamber caused by a marked ectasia of Descemet layer, which is why air was injected into the anterior chamber and a correct adhesion of donor cornea to recipient bed was obtained
 

Results

the patient is currently in his seventh postoperative month without complications and is in the process of removing sutures. His visual acuity improved from LogMar +2.00 to LogMar +0.50.

Conclusions

The Melles manual technique for deep anterior lamellar keratoplasty allows us to approach cases with extreme keratometries, allowing us to avoid penetrating keratoplasty and its possible complications.